Evaluation of functional outcomes following rectus diastasis repair-an up-to-date literature review.

A Olsson, O Kiwanuka, G Sandblom, O Stackelberg

Journal: Hernia : the journal of hernias and abdominal wall surgery 2021;25(4):905-914

PMID: 34302558

Abstract

INTRODUCTION

Over the last decade rectus diastasis has gained attention as a condition that may benefit from surgery. Numerous surgical techniques have been presented but scientifically proper studies reporting functional outcome are few and evidence is incomplete. The aim of this up-to-date review is to analyse the outcomes of rectus diastasis repair in recently published papers, focusing on functional changes following surgery.

METHOD

A comprehensive search in PubMed and Web of Science was performed. Suitable papers were selected using titles and abstracts with terms suggesting surgical treatment of rectus diastasis. All abstracts were scrutinised, and irrelevant studies excluded in four stages. Reports providing original data, including outcome assessment following surgery, were included.

RESULT

Ten papers with a total of 780 patients were found to fulfil the search criteria. Study design, surgical procedure, follow-up time, functional outcome and assessment instruments were compiled. All included studies reported improvements in a variety of functional aspects regardless of surgical method. The outcomes assessed include core stability, back pain, abdominal pain, posture, urinary incontinence, abdominal muscle strength and quality of life.

CONCLUSION

The results of this review show that surgical repair of rectus diastasis is a safe and effective treatment that improves functional disability. However, the absence of standardized instruments for assessing outcome makes it impossible to compare studies. Since indications for surgery are relative and related to core function, valid instruments for assessing indication and outcome are needed to ensure benefit of the procedure.

© 2021. The Author(s).

Address: Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden. [email protected].; Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden.; Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden.

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